Governors from Maine to Alaska tackle National Heroin Epidemic

Posted 3/2/2016 by Angelo M. Valente

As the Heroin Epidemic continues to impact small towns, suburbs and cities throughout the country the National Governors Association has recently tackled the issue in this recent New York Times editorial. They are developing recommendations that include revised prescribing protocols and more active patient education. New Jersey's legislature has also been developing their own response that include a bill that would require doctors to have a conversation with parents of child prior to prescribing any opioids and also recommending alternative treatment options when they are available.

from the NYTimes.com:

Governors Unite in the War Against Opioids

State governments are at the front lines of the country’s epidemic of drug overdose deaths. That’s why it is important that the National Governors Association says it will come up with protocols for dispensing prescription painkillers that are among the biggest sources of addiction and abuse in the country.

The protocols, or guidelines, would restrict how and under what circumstances doctors could prescribe a category of pain drugs known as opioids. They might, for example, impose limits on how many pills doctors could prescribe to patients who have had minor surgery or dental procedures.

More than 47,000 people died from drug overdoses in 2014; 61 percent of those deaths involved opioids like the prescription drug oxycodone, and illegal substances like heroin, according to the Centers for Disease Control and Prevention. The rate of drug overdose deaths has increased by 140 percent since 2000, while prescriptions for opioid painkillers have quadrupled in roughly the same period. Experts say many patients who become addicted go on to use heroin and other illegal opioids.

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Gov. Peter Shumlin of Vermont testifying on Capitol Hill about the epidemic of heroin and prescription drug abuse.CreditAlex Brandon/Associated Press

The governors association’s health and human services committee is expected to present the protocols at a meeting in July. Legislators and governors in each state could then adopt those standards into their laws and regulations, which would make meaningful enforcement against excessive prescriptions more likely. Some leaders intend to act even sooner. The governors of New England states like Vermont and Massachusetts say they will work together to come up with common prescribing guidelines for their states within a few weeks.

Done right, the guidelines — being developed with medical specialists, government regulators, insurance companies and other experts — should reduce the number of excessive prescriptions. Similar efforts by some states and insurance companies have shown promising results. Florida, for example, reduced its prescription drug overdose death rate by 23 percentbetween 2010 and 2012 after it strengthened its prescribing laws andincreased enforcement against doctors who dispensed too many pills, often because it was financially lucrative. And Blue Cross Blue Shield of Massachusetts has reduced opioid use by, among other things, requiring some patients to use just one pharmacy to fill their prescriptions.

On the federal front, the C.D.C. is expected to publish voluntary guidelines soon for doctors in treating chronic pain in adults. And Congress is considering a bill that would require the secretary of health and human services to convene a task force to develop best practices for prescribing painkillers.

Drug companies and some doctors will push back against any limits on prescriptions enacted by state lawmakers. The American Medical Association says the decision to prescribe drugs should “stay in the hands of physicians.” Of course, doctors should have discretion to make medical decisions, including what drugs to use, but state governments also have a duty to protect people by placing sensible limits on the use of risky substances.

Obviously, reducing the number of opioid prescriptions only addresses part of the addiction problem. Earlier this month, President Obama proposed spending $1.1 billion on treatment and prevention programs. And Senator Jeanne Shaheen, Democrat of New Hampshire, has proposed $600 millionin emergency funding to address the opioid crisis. These requests are surely reasonable, given the size of the national problem.